Impoverished Black Teens Talk About Depression Differently

Depression is an equal opportunity malady. It affects people from all walks of life, be they rich or poor, young or old, or black or white. But it’s apparent there are some groups who more vulnerable to depression than others, such as those living in poverty or who regularly face discrimination. A recent study, published in the Journal of the Society for Social Work and Research, suggests that different groups of people also talk about depression differently. In particular, poorer black kids discuss their feelings of depression differently than other demographic groups.

The researchers interviewed more than 800 teens whose families lived on housing assistance in four major cities, including New York City and Washington DC. The teens were asked to fill out a standard survey used to diagnose depression, called the Centre for Epidemiologic Studies Depression Scale (CES-D). They were also asked if they had thought about attempting suicide within the past year and if they had thought about a specific plan.

Looking specifically at the 792 black teens who took the survey, the researchers found that 25 per cent showed symptoms of moderate to severe depression; another 17 per cent met the criteria for mild depression; and 39 teens said they had at least thought about suicide recently.

That’s alarming enough, given that the rate of clinical depression among the general population hovers around 7 per cent. But when the researchers dug deeper, they found something else.

Most research has found that people tend to express their depression in one of four major ways, which can be measured through the items in the CES-D they identify with. These categories are somatic (physical) complaints, such as feeling unable to sleep well; interpersonal relations, such as fearing people dislike them; depressive affect, meaning having explicit feelings of sadness; or a lack of positive affect, meaning they haven’t felt happy or hopeful as of late.

But these patterns didn’t apply to the black teens the researchers surveyed.

“Based on previous literature and our own research findings, compared with adults and adolescents of other racial/ethnic groups, black adolescents experiencing depressive symptoms tend to express their depressed feelings by complaining about conflicts with others and physical pains and aches [at the same time],” lead author Wenhua Lu, an assistant professor of childhood studies at Rutgers University, told me in an email.

This distinction is important, Lu says, because doctors and mental health professionals may not recognise a black teen’s depression if it doesn’t fit into a conventional pattern of symptoms. “For example, if a black adolescent keeps complaining about physical discomforts that cannot be medically explained or diagnosed for one week or two, it may be a warning sign of depression,” Lu says.

And these differences could translate to different treatments too. “As to treatment, interpersonal psychotherapy for adolescents, which addresses common adolescent developmental issues, such as development of dyadic interpersonal relations and peer pressure, may be more effective for black adolescents,” she says.

That might be easier said than done, though. Another recent study published this month found counsellors are often ill-equipped to deal with issues specific to marginalised people. It found that at least two-thirds of counsellors had never received training on how to identify or treat race-based trauma. And the problem seems to be getting worse for younger black kids, too: A recent study found that the suicide rate among kids younger than 12 has more than doubled for black children in the past two decades.

Lu hopes more research will find out if teens from other different racial/ethnic groups express depression in distinct ways, too, as some studies have suggested. Other studies are needed, she adds, to specifically explore what historical, cultural, personal, and environmental factors could contribute to these differences. [Journal of the Society for Social Work and Research]